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Meta-Analysis
. 2022 Feb 12;14(4):777.
doi: 10.3390/nu14040777.

The Dose-Response Associations of Sugar-Sweetened Beverage Intake with the Risk of Stroke, Depression, Cancer, and Cause-Specific Mortality: A Systematic Review and Meta-Analysis of Prospective Studies

Yuanxin Wang  1 , Renqing Zhao  1 , Bin Wang  1 , Chen Zhao  1 , Baishu Zhu  1 , Xin Tian  1
Affiliations
Meta-Analysis

The Dose-Response Associations of Sugar-Sweetened Beverage Intake with the Risk of Stroke, Depression, Cancer, and Cause-Specific Mortality: A Systematic Review and Meta-Analysis of Prospective Studies

Yuanxin Wang et al. Nutrients. .

Abstract

The associations between sugar-sweetened beverage (SSB) consumption and the risk of stroke, depression, cancer, and cause-specific mortality have not been determined, and the quantitative aspects of this link remain unclear. This meta-analysis therefore conducted a systematic review and dose-response analysis to determine their causal links. The database searches were conducted in PubMed, Cochrane library, Embase, Web of Science up to 10 November 2021. The intervention effects were evaluated by relative risk (RR) with 95% confidences (CI). Thirty-two articles met the inclusion criteria. Higher levels of SSB consumption significantly increased the risk of stroke (RR 1.12, 95% CI 1.03-1.23), depression (1.25, 1.11-1.41), cancer (1.10, 1.03-1.17), and all-cause mortality (1.08, 1.05-1.11) compared with none or lower SSB intake. The associations were dose-dependent, with per 250 mL increment of SSB intake daily increasing the risk of stroke, depression, cancer, and all-cause mortality by RR 1.09 (1.03-1.15), 1.08 (1.06-1.10), 1.17 (1.04-1.32), and 1.07 (1.03-1.11), respectively. The link was curved for depression and cancer risk (pnon-linear < 0.05). Subgroup analysis suggested that higher SSB intake increased ischemic stroke by 10%, CVD-caused mortality by 13%, and cancer-caused mortality by 6.0% than none or lower SSB consumption. It is suggested that SSB accounts for a leading risk factor of stroke, depression, cancer, and mortality, and that the risk rises in parallel with the increment of SSB intake (and is affected by participant characteristics).

Keywords: cancer; depression; mortality; stroke; sugar-sweetened beverage.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow chart for the selection of studies.
Figure 2
Figure 2
Overall analysis of the associations of sugar-sweetened beverage (SSB) intake with the risk of stroke, depression, cancer, and mortality. The square indicates relative risk (RR) with 95% confidence interval (CI). The rhombus denotes effects sizes.
Figure 3
Figure 3
Subgroup analysis of the associations between sugar-sweetened beverage (SSB) intake and stroke stratified by the types of stroke, age, body mass index (BMI), energy intake daily, location, and follow-up years. The square indicates relative risk (RR) with 95% confidence interval (CI).
Figure 4
Figure 4
Linear or spline regression of the link between sugar-sweetened beverage (SSB) intake and the risk of stroke, depression, cancer, and mortality. RR: relative risk. CI: confidence interval.
Figure 5
Figure 5
Subgroup analysis of the associations between sugar-sweetened beverage (SSB) intake and depression stratified by age, body mass index (BMI), energy intake daily, location, and follow-up years. The square indicates relative risk (RR) with 95% confidence interval (CI).
Figure 6
Figure 6
Subgroup analysis of the associations between sugar-sweetened beverage (SSB) intake and caner stratified by the types of cancer, age, body mass index (BMI), energy intake daily, location, and follow-up years. The square indicates relative risk (RR) with 95% confidence interval (CI).
Figure 7
Figure 7
Subgroup analysis of the associations between sugar-sweetened beverage (SSB) and mortality stratified by cause-specific mortality, age, body mass index (BMI), energy intake daily, location, and follow-up years. The square indicates relative risk (RR) with 95% confidence interval (CI).
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